Gun Violence and Pretrial Detention—Addressing Public Perception and Public Health

Abstract

State and local policymakers are tasked with promoting public safety, often through passing legislation. In doing so, they must attend to serious public health matters, including growing concerns over myriad consequences of mass incarceration. Jahn and colleagues 1 investigated how these priorities overlap by estimating the association between the implementation of bail reform legislation and rates of gun violence in New Jersey. Using synthetic control methods, the authors compared postpolicy trends in gun violence against a matched comparison group of 36 jurisdictions that did not implement bail reform. The authors found no statistically significant changes in the rates (per 100 000) of firearm mortality or shootings following the implementation of bail reform in New Jersey, compared with the synthetic control group. As such, their findings did not support the assertion of commentators who hastily branded bail reform as a progressive policy that would seriously threaten public safety. Specifically, during the study period, the policy change did not result in an increase in gun violence at the community level, and the number of individuals held in pretrial detention in fact decreased.With respect to policy, Jahn and colleagues 1 suggest that to reduce gun violence and welldocumented racial disparities, responses should be effective and fair. Recent estimates from the Prison Policy Initiative 2 report that approximately 1.9 million people in the US are incarcerated across federal, state, local, and tribal correctional facilities, for a per capita rate of 583 per 100 000 people.For context, the incarceration rates per 100 000 people in other countries, including Norway (54), Canada (104), Portugal (111), China (121), Mexico (166), South Africa (248), and Trinidad and Tobago (276), are far lower. Furthermore, of the approximately 550 000 individuals held in local jails across the country, 448 000, or 81.45%, have not been convicted and remain in pretrial detention largely due to financial hardship. 2 As such, bail reform passed in New Jersey in 2017 eliminated cash bail and, instead, instituted a risk assessment wherein judges weighed factors such as prior criminal record in determining whether to release arrestees pretrial. Incarceration has numerous deleterious health outcomes, including increased prevalence of infectious diseases, chronic medical conditions, aggravated substance abuse, exacerbated mental health conditions, and increased mortality rates. 3 Furthermore, incarcerated individuals' family members bear the brunt of a wide range of collateral consequences. Specifically, an abundant body of research suggests that children with incarcerated parents develop behavioral and mental health problems during adolescence and are at heightened risk of depression, anxiety, and addiction into adulthood. 3 Mass incarceration, including holding arrestees in pretrial detention, has both direct and indirect adverse health outcomes, adversely impacting entire communities.Alarming rates of gun violence are a common public ...